IPPE Grading Controversy: What's my Recourse?

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Hypersomnolence

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I am very concerned about the grade I will be getting for my IPPE rotation - I think the grading system is just way too subjective. It seems like I unfairly bear the brute of my preceptor's anger. For example, if a script isn't filled on time, I get unfairly scolded: It would've been filled in 15 minutes if I wasn't the only one answering the phone and helping customers: my preceptor spends too much of her time taking personal phone calls, visiting with her friends who seem to conveniently stop by at peak times, and texting (all of which I never do!) 🙁

I have arrived everyday on time, maintain professional dress code to a T, am highly courteous to patients and fellow employees, work very hard at filling scripts on time. Yet the grading is all just a subjective viewpoint.

At this point I am very concerned about what to do. If I do file a complaint about my preceptor then I will surely be in hot water when the retaliatory actions hit. Please let me know what you would do. Thanks.

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I am very concerned about the grade I will be getting for my IPPE rotation - I think the grading system is just way too subjective. It seems like I unfairly bear the brute of my preceptor's anger. For example, if a script isn't filled on time, I get unfairly scolded: It would've been filled in 15 minutes if I wasn't the only one answering the phone and helping customers: my preceptor spends too much of her time taking personal phone calls, visiting with her friends who seem to conveniently stop by at peak times, taking smoke breaks, and texting (all of which I never do!) 🙁

I have arrived everyday on time, maintain professional dress code to a T, am highly courteous to patients and fellow employees, work very hard at filling scripts on time. Yet the grading is all just a subjective viewpoint.

At this point I am very concerned about what to do. If I do file a complaint about my preceptor then I will surely be in hot water when the retalliatory actions hit. Please let me know what you would do. Thanks.

If you want to send me a PM, I can tell you about what I think, since this sounds personal, and you'd probably want specific advice, which works well for specific situations.
 
I am very concerned about the grade I will be getting for my IPPE rotation - I think the grading system is just way too subjective. It seems like I unfairly bear the brute of my preceptor's anger. For example, if a script isn't filled on time, I get unfairly scolded: It would've been filled in 15 minutes if I wasn't the only one answering the phone and helping customers: my preceptor spends too much of her time taking personal phone calls, visiting with her friends who seem to conveniently stop by at peak times, taking smoke breaks, and texting (all of which I never do!) 🙁

I have arrived everyday on time, maintain professional dress code to a T, am highly courteous to patients and fellow employees, work very hard at filling scripts on time. Yet the grading is all just a subjective viewpoint.

At this point I am very concerned about what to do. If I do file a complaint about my preceptor then I will surely be in hot water when the retalliatory actions hit. Please let me know what you would do. Thanks.

It has been 3 years since my community IPPE, but you might want to re-visit what you're ALLOWED to do at your IPPE. For us, we weren't allowed to do anything but shadow the preceptor, ask questions, ect. The director of the IPPE made it clear to us and the preceptors that we were not to be doing any actual pharmacy work (i.e answering calls, filling, entering, ect). It sounds to me like they are treating you like an intern, not a student on an IPPE. Review what you are actually supposed to be doing, and if yours is anything like mine you can always just tell your preceptor that you aren't there to do those things, and if they complain, go to your IPPE director.
 
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It has been 3 years since my community IPPE, but you might want to re-visit what you're ALLOWED to do at your IPPE. For us, we weren't allowed to do anything but shadow the preceptor, ask questions, ect. The director of the IPPE made it clear to us and the preceptors that we were not to be doing any actual pharmacy work (i.e answering calls, filling, entering, ect). It sounds to me like they are treating you like an intern, not a student on an IPPE. Review what you are actually supposed to be doing, and if yours is anything like mine you can always just tell your preceptor that you aren't there to do those things, and if they complain, go to your IPPE director.

Good call but what's odd is that one of the evaluation criteria includes the word "dispensing". I agree with you, we're pretty much free tech labor. In fact, they decreased the tech hours when the students came on board.
 
One more thing worth mentioning: WHAT IS THE POINT OF THOSE FIVE IPPE COMMUNITY PAPERS THEY MAKE US WRITE IF THEY'RE NOT GRADED?!

What frustrates me is that I can put my heart into writing an exquisite paper, yet since they're not graded, they won't do anything for my final grade. Can't there be anything about the IPPE grading system that is not totally subjective? With grading a paper, you can appeal your grade by having it read again and point out how it fulfills the rubric criteria (NLM citation format, grammar, use of evidence-based medicine, answers the questions, etc). But with a purely subjective preceptor evaluation, I can't show my dean what went on at the pharmacy. I'm just really frustrated right now.
 
Wow, had no idea people at other schools are stressing out over IPPE so much.

This is why IPPE should be pass-fail. If you put in the work, even if the preceptor doesn't like you, he/she'll find it pretty hard to fail you.

But how bad is your grade going to get? If it's an A vs. a B, it's not a big deal in the grand scheme of things, as I bet it's not too many credits. If it's an A vs. a C or D, I guess just try to talk to the preceptor about what you're doing wrong and reason with them that you're trying best, and hope that the preceptor will evaluate you well.

And are you sure your papers don't get graded at all? I believe for us everything in our portfolio is graded for completion, including evaluations, charts we have to fill out, papers, etc...
 
It has been 3 years since my community IPPE, but you might want to re-visit what you're ALLOWED to do at your IPPE. For us, we weren't allowed to do anything but shadow the preceptor, ask questions, ect. The director of the IPPE made it clear to us and the preceptors that we were not to be doing any actual pharmacy work (i.e answering calls, filling, entering, ect). It sounds to me like they are treating you like an intern, not a student on an IPPE. Review what you are actually supposed to be doing, and if yours is anything like mine you can always just tell your preceptor that you aren't there to do those things, and if they complain, go to your IPPE director.

That is so different than my IPPE. We started within the first two weeks of school and we were expected to do pharmacy work. We had to do OTC consults, transfers, and patient counseling throughout the year in addition to tech duties even though we were just P1s. Just standing around watching someone work sounds really boring. How many hours did you have to do that?
 
I am very concerned about the grade I will be getting for my IPPE rotation - I think the grading system is just way too subjective. It seems like I unfairly bear the brute of my preceptor's anger. For example, if a script isn't filled on time, I get unfairly scolded: It would've been filled in 15 minutes if I wasn't the only one answering the phone and helping customers: my preceptor spends too much of her time taking personal phone calls, visiting with her friends who seem to conveniently stop by at peak times, taking smoke breaks, and texting (all of which I never do!) 🙁

I have arrived everyday on time, maintain professional dress code to a T, am highly courteous to patients and fellow employees, work very hard at filling scripts on time. Yet the grading is all just a subjective viewpoint.

At this point I am very concerned about what to do. If I do file a complaint about my preceptor then I will surely be in hot water when the retalliatory actions hit. Please let me know what you would do. Thanks.

That is the way IPPEs are. Some people just get unlucky when getting a preceptor. You should talk to your school and the people in charge of rotations.That should be confidential and should not affect your grade. Just ask them what options you have. Your rotations are for you to learn but a lot of the time we are just free labor and we just have to get through it and move on. I have had one bad rotation and I put a bad evaluation for it but I am sure another student will be there soon because the school needs places to put people.
 
I would talk to your IPPE coordinator. At our school, ours encourages us to bring up any issues we have (not minor issues but something of this nature). Is this an option for you?
 
You shouldn't be filling scripts or doing tech work at your IPPE...this was made clear to us and our preceptor at the start of my community IPPE during P-1 year. I don't know what the policy is at your school, but I would imagine it would be similar.

Bring the issue up with your experiential coordinator...we had 1-2 isolated incidents last year involving preceptors and my school dropped them as a site. As long as you pass, you're fine...nail your preceptor in the post-IPPE review/evaluation and encourage your school to drop them.

if your preceptor fails you, then activate the appeals process. In the meantime, get your complaints documented with your experiential coordinator to have an advocate in place. Stress to them you want this to remain confidential until the end. Is there anyone else at the workplace who can vouch that you attended on time all the time?

If it's as bad as you say, see if you can get placed somewhere else. It might be too late for that.
 
One more thing worth mentioning: WHAT IS THE POINT OF THOSE FIVE IPPE COMMUNITY PAPERS THEY MAKE US WRITE IF THEY'RE NOT GRADED?!

Five? good lord, I had two...i spent like 15mins on each of them. Who the heck wants to grade five papers at your school?

i could barely find enough material in community to write two papers (slow store).
 
Go to the school if you dare. Otherwise, you are at their whim. IPPEs are stupid anyway. Yeah, let's take away from final year rotations when you can actually apply knowledge and send these kids out there early without a clue as to what they are doing!
 
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You shouldn't be filling scripts or doing tech work at your IPPE...this was made clear to us and our preceptor at the start of my community IPPE during P-1 year. I don't know what the policy is at your school, but I would imagine it would be similar.

Bring the issue up with your experiential coordinator...we had 1-2 isolated incidents last year involving preceptors and my school dropped them as a site. As long as you pass, you're fine...nail your preceptor in the post-IPPE review/evaluation and encourage your school to drop them.

if your preceptor fails you, then activate the appeals process. In the meantime, get your complaints documented with your experiential coordinator to have an advocate in place. Stress to them you want this to remain confidential until the end. Is there anyone else at the workplace who can vouch that you attended on time all the time?

If it's as bad as you say, see if you can get placed somewhere else. It might be too late for that.

I think in the future when your class size expands it will be hard for a school to keep up with these incidences.

That is the only problem I can think about so far.
 
I'm at a hospital right now for an IPPE, we're filling prescriptions, making IVs, doing Epogen reviews and vancomycin reviews, going up to the floors by ourselves to review charts, it's awesome.

That sounds like a normal, boring ass day. That **** gets old in a few weeks.
 
That sounds like a normal, boring ass day. That **** gets old in a few weeks.

It's a 4 week IPPE, I'll be done with it by June 25. The one thing that annoys the **** out of me at the hospital is this little bitch called the formulary. A couple of times I was up on the floors, the physicians asked me a few questions about drug recommendations, unfortunately none of my suggestions were on the formulary.

How the **** is the generic for Toprol XL not on the formulary?
 
It's a 4 week IPPE, I'll be done with it by June 25. The one thing that annoys the **** out of me at the hospital is this little bitch called the formulary. A couple of times I was up on the floors, the physicians asked me a few questions about drug recommendations, unfortunately none of my suggestions were on the formulary.

How the **** is the generic for Toprol XL not on the formulary?

Because the director made a deal with someone to get an alternative for cheaper. Ask for a copy of the formulary.
 
Go to the school if you dare. Otherwise, you are at their whim. IPPEs are stupid anyway. Yeah, let's take away from final year rotations when you can actually apply knowledge and send these kids out there early without a clue as to what they are doing!

Isn't IPPE in addition to APPE? We did 10 week so of IPPE and still do a full year of APPE.
 
There are less final year rotations to allow the mid year useless crap.

really? i thought P-4 rotations were untouched (we have 6 x 6 weeks of rotations + 1 6 week period off). That's 42 weeks in a 52 week period...
 
really? i thought P-4 rotations were untouched (we have 6 x 6 weeks of rotations + 1 6 week period off). That's 42 weeks in a 52 week period...

It went from 11 calendar month long rotations with most of December off when I was there...to 9 rotations with 2 months off...and now I think its 8 X 5 weeks.

Rotations used to be hell...now they are for the weak. The WEAK!!!!
 
It has been 3 years since my community IPPE, but you might want to re-visit what you're ALLOWED to do at your IPPE. For us, we weren't allowed to do anything but shadow the preceptor, ask questions, ect. The director of the IPPE made it clear to us and the preceptors that we were not to be doing any actual pharmacy work (i.e answering calls, filling, entering, ect). It sounds to me like they are treating you like an intern, not a student on an IPPE. Review what you are actually supposed to be doing, and if yours is anything like mine you can always just tell your preceptor that you aren't there to do those things, and if they complain, go to your IPPE director.

What Sylar says is true. We weren't suppose to be used as free labor. Basically we were suppose to observe, ask questions, and work on our notebook.
 
Some details I have to withhold because it can easily expose my identify and ya never know who reads this PUBLIC forum.

Update:
So today was my last day of the rotation. Yesterday was my last day working with my preceptor, as she had today off. Thus, yesterday I gave her my evaluation form to fill out and she told me she didn't "have time" to complete the form, even though they were handed to her several hours before the end of her shift. The form is two pages long and all she has to do is rate my performance on a numerical scale for several criteria. It's not that hard! She told me she'd stop by the next day (my last day - today) and drop them off. I was not happy cuz yesterday, instead of taking a few minutes to fill out the forms she did more meaningful things like text and talk on the phone. Well, today she didn't stay true to her word and she never brought the forms to me! She called texted a friend of hers, who was working today, and told her to pass on the message that she couldn't make it. Don't ya think it would've been more professional to explain the situation over the phone to me and actually apologize? Cuz now I'm expected to stop by tomorrow and pick up the evaluation forms, even though they were supposed to be reviewed with me, not just handed to me.

What do you think I should do in this situation?
 
Some details I have to withhold because it can easily expose my identify and ya never know who reads this PUBLIC forum.

Update:
So today was my last day of the rotation. Yesterday was my last day working with my preceptor, as she had today off. Thus, yesterday I gave her my evaluation form to fill out and she told me she didn't "have time" to complete the form, even though they were handed to her several hours before the end of her shift. The form is two pages long and all she has to do is rate my performance on a numerical scale for several criteria. It's not that hard! She told me she'd stop by the next day (my last day - today) and drop them off. I was not happy cuz yesterday, instead of taking a few minutes to fill out the forms she did more meaningful things like text and talk on the phone. Well, today she didn't stay true to her word and she never brought the forms to me! She called texted a friend of hers, who was working today, and told her to pass on the message that she couldn't make it. Don't ya think it would've been more professional to explain the situation over the phone to me and actually apologize? Cuz now I'm expected to stop by tomorrow and pick up the evaluation forms, even though they were supposed to be reviewed with me, not just handed to me.

What do you think I should do in this situation?

Talk to your IPPE director and tell them what's going on. The key is constant dialogue, if you just bring it up at the last minute they will think you're making excuses...especially if the preceptor says the opposite of what you said.

I agree with WVUPharm when it comes to IPPE, I had an intern one time and god bless the kid but he didn't know diddly squat. He really wanted to get involved in things and learn but we were told to let him watch and observe and fill out those sheets he has to do or whatever.
 
Someone didn't get the memo at our sites. We're doing everything at the pharmacy on top of the school's work as well as side projects that the preceptor throws in. Our reward, 1 1/2 hour lunch breaks. For example, today a doctor called up because he needed advise on whether to give Zosyn or Invanz. Our preceptor just put him on hold and told me to get on the phone and figure it out.

The patient was an 82 year old female, 5'1, 122 lbs with nomosocial pneumonia. Serum creatinine was 2.6. Ended up telling the doctor to dose her with Zosyn 2.25 grams every 8 hours.
 
Someone didn't get the memo at our sites. We're doing everything at the pharmacy on top of the school's work as well as side projects that the preceptor throws in. Our reward, 1 1/2 hour lunch breaks. For example, today a doctor called up because he needed advise on whether to give Zosyn or Invanz. Our preceptor just put him on hold and told me to get on the phone and figure it out.

The patient was an 82 year old female, 5'1, 122 lbs with nomosocial pneumonia. Serum creatinine was 2.6. Ended up telling the doctor to dose her with Zosyn 2.25 grams every 8 hours.

Reason for admission? What unit? Ventilation? Comorbidities? Allergies? Medications?

Why do you suspect pneumonia and what organisms are you looking to cover?
 
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For future reference:
Does anyone know the legality behind using a discrete pen video camera, while on rotations? I could easily clip it to my white coat. I know it sounds pretty crazy but this may be my only way to provide indisputable evidence of the things that go on. I would only use the footage as a means of evidence, if God forbid this scenario repeats itself. Check this out:
http://www.spytechs.com/spy_cameras/pen-camera-dv640.htm
 
For future reference:
Does anyone know the legality behind using a discrete pen video camera, while on rotations? I could easily clip it to my white coat. I know it sounds pretty crazy but this may be my only way to provide indisputable evidence of the things that go on. I would only use the footage as a means of evidence, if God forbid this scenario repeats itself. Check this out:
http://www.spytechs.com/spy_cameras/pen-camera-dv640.htm

I have to get one of those. My coordinator would die of boredom after watching one single day of my "free labor" rotation.
 
I don't think HIPAA would allow that if somehow patient information got into the footage...

How would that be a violation if he/she is sharing this with a staff member that is a registered pharmacist?

The legality of it is different state to state. I know in Virginia where my mother lives it's legal to secretly record a conversation as long as one person is aware of the recording. So if you recorded yourself talking to the preceptor then you have your one party consenting....you! But I'm not an attorney so take that with a grain of salt.
 
Reason for admission? What unit? Ventilation? Comorbidities? Allergies? Medications?

Why do you suspect pneumonia and what organisms are you looking to cover?

It's a geriatric hospital/long term care facility. Usually they move patients to this facility after they are done at the emergency care or critical care center in the main hospital.

All I was told was that the diagnosis was pneumonia, no other information and that the physician wanted either Invanz or Zosyn. The person was recently brought into the center, so their charts wouldn't be up yet. Could have given either one. Invanz would have been 500 mg daily via IV (CrCl was ~12 ml/min), but we only had 1 gram vials available. Instead of wasting half a vial every time, we decided to go with the Zosyn.
 
It's a geriatric hospital/long term care facility. Usually they move patients to this facility after they are done at the emergency care or critical care center in the main hospital.

All I was told was that the diagnosis was pneumonia, no other information and that the physician wanted either Invanz or Zosyn. The person was recently brought into the center, so their charts wouldn't be up yet. Could have given either one. Invanz would have been 500 mg daily via IV (CrCl was ~12 ml/min), but we only had 1 gram vials available. Instead of wasting half a vial every time, we decided to go with the Zosyn.

That's not the reason to do it...

If you're going to make a decision for a drug, you need to get more information. Just a general question: what does pip/tazo cover that ertapenem doesn't?
 
How would that be a violation if he/she is sharing this with a staff member that is a registered pharmacist?

The legality of it is different state to state. I know in Virginia where my mother lives it's legal to secretly record a conversation as long as one person is aware of the recording. So if you recorded yourself talking to the preceptor then you have your one party consenting....you! But I'm not an attorney so take that with a grain of salt.

Where I work, the only people that have access to PHI are the people directly incolved in that patient's care. So, whether it is another staff member is irrelevant if that staff member is not providing patient care. Trust me- people have gotten in trouble in my dept. for that. Furthermore, patient contact info/med information would be on tape which, if I was one of those patients, I would be pissed. We can't even throw patient labels into the trash. Besides, he wants to show it to the school faculty who isn't privy to that information (or are they?). Who knows where that tape would end up? And I wasn't aware HIPAA laws vary state to state since it is a federal law- but what do I know...
 
http://www.hhs.gov/ocr/privacy/hipaa/understanding/index.html

The HIPAA Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights with respect to that information. At the same time, the Privacy Rule is balanced so that it permits the disclosure of personal health information needed for patient care and other important purposes.

http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html

State Law

Preemption.
In general, State laws that are contrary to the Privacy Rule are preempted by the federal requirements, which means that the federal requirements will apply. “Contrary” means that it would be impossible for a covered entity to comply with both the State and federal requirements, or that the provision of State law is an obstacle to accomplishing the full purposes and objectives of the Administrative Simplification provisions of HIPAA. The Privacy Rule provides exceptions to the general rule of federal preemption for contrary State laws that (1) relate to the privacy of individually identifiable health information and provide greater privacy protections or privacy rights with respect to such information, (2) provide for the reporting of disease or injury, child abuse, birth, or death, or for public health surveillance, investigation, or intervention, or (3) require certain health plan reporting, such as for management or financial audits.

Exception Determination. In addition, preemption of a contrary State law will not occur if HHS determines, in response to a request from a State or other entity or person, that the State law:

  • Is necessary to prevent fraud and abuse related to the provision of or payment for health care,
  • Is necessary to ensure appropriate State regulation of insurance and health plans to the extent expressly authorized by statute or regulation,
  • Is necessary for State reporting on health care delivery or costs,
  • Is necessary for purposes of serving a compelling public health, safety, or welfare need, and, if a Privacy Rule provision is at issue, if the Secretary determines that the intrusion into privacy is warranted when balanced against the need to be served; or
  • Has as its principal purpose the regulation of the manufacture, registration, distribution, dispensing, or other control of any controlled substances (as defined in 21 U.S.C. 802), or that is deemed a controlled substance by State law.

http://www.hhs.gov/ocr/privacy/hipaa/understanding/srsummary.html

State Law

  • Preemption. In general, State laws that are contrary to the HIPAA regulations are preempted by the federal requirements, which means that the federal requirements will apply. “Contrary” means that it would be impossible for a covered entity to comply with both the State and federal requirements, or that the provision of State law is an obstacle to accomplishing the full purposes and objectives of the Administrative Simplification provisions of HIPAA.
 
Where I work, the only people that have access to PHI are the people directly incolved in that patient's care. So, whether it is another staff member is irrelevant if that staff member is not providing patient care. Trust me- people have gotten in trouble in my dept. for that. Furthermore, patient contact info/med information would be on tape which, if I was one of those patients, I would be pissed. We can't even throw patient labels into the trash. Besides, he wants to show it to the school faculty who isn't privy to that information (or are they?). Who knows where that tape would end up? And I wasn't aware HIPAA laws vary state to state since it is a federal law- but what do I know...

I'm pretty sure he/she meant the legality of the TAPING varies from state to state, which is true.
 
Where I work, the only people that have access to PHI are the people directly incolved in that patient's care. So, whether it is another staff member is irrelevant if that staff member is not providing patient care. Trust me- people have gotten in trouble in my dept. for that. Furthermore, patient contact info/med information would be on tape which, if I was one of those patients, I would be pissed. We can't even throw patient labels into the trash. Besides, he wants to show it to the school faculty who isn't privy to that information (or are they?). Who knows where that tape would end up? And I wasn't aware HIPAA laws vary state to state since it is a federal law- but what do I know...

No no no, I'm talking about the legality of recording conversations in general. Not HIPAA.

If the OP really wants to record this then I say do audio only, that way you can use Audacity to edit out any patient information that might be overheard of the tape. But look up the legality of it in your state first.
 
Where I work, the only people that have access to PHI are the people directly incolved in that patient's care. So, whether it is another staff member is irrelevant if that staff member is not providing patient care. Trust me- people have gotten in trouble in my dept. for that. Furthermore, patient contact info/med information would be on tape which, if I was one of those patients, I would be pissed. We can't even throw patient labels into the trash. Besides, he wants to show it to the school faculty who isn't privy to that information (or are they?). Who knows where that tape would end up? And I wasn't aware HIPAA laws vary state to state since it is a federal law- but what do I know...

If I share the recording with pharmacy school faculty, I would limit the footage to only the atrocities committed by my preceptor. Any footage involving the disclosure of patient info would be disposed of.

And I could make a very good case for using this so-called "spy camera", not just as a source of evidence but also to improve my professional competency. For example, if an irate patient comes in and tells me I shorted their #60 Oxycontin, claiming I gave them only 30, I can refer back to the recording to substantiate my pill count. This could be a VERY useful tool in controlling fraud and protecting my license!
 
If I share the recording with pharmacy school faculty, I would limit the footage to only the atrocities committed by my preceptor. Any footage involving the disclosure of patient info would be disposed of.

And I could make a very good case for using this so-called "spy camera", not just as a source of evidence but also to improve my professional competency. For example, if an irate patient comes in and tells me I shorted their #60 Oxycontin, claiming I gave them only 30, I can refer back to the recording to substantiate my pill count. This could be a VERY useful tool in controlling fraud and protecting my license!

Again, I was referring to recording audio and not video. That's something you need to look up in your state.
 
No no no, I'm talking about the legality of recording conversations in general. Not HIPAA.

If the OP really wants to record this then I say do audio only, that way you can use Audacity to edit out any patient information that might be overheard of the tape. But look up the legality of it in your state first.

Sorry, I misunderstood and yeah, that is a good idea about editing out patient information.
 
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